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<br />RECEIVED <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Colorado Lien Company <br />M-1985-038 <br />Rifle Quarry <br />September 26, 2003 <br />SEP 2 2 2003 <br />Division of Minerals and Geology <br />$688.00 (Due on or before your anniversary date) <br />Garfield <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, an operator <br />shall-submit-the annual-fee,-a-report-and_map showing the .extent of_current disturbances to affected_land,_- . <br />reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur <br />during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach ynnr revised written anmral rennrt and anneal report m ~n to this form- Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Lecia Craft <br />Permittee Name: Colorado Lien Company <br />Address: P.O. Box 767 <br />Rapid City, SD 57709 <br />Phone Number: (605) 342-7224 <br />Fax Number: (605) 394-7246 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />_~~~ <br />Signature of Corporat officer, Owner, or Designee <br />q/!~103 <br />Date <br />MdPERMITMASTERDOCUMENTSU9-AF-0I <br />